Demand for nurse practitioners and physician assistants is growing as Long Island’s population ages and the medical profession evolves.
People in these jobs provide patient care that doctors have historically delivered, ranging from routine examinations to more advanced care.
“These are both invaluable support specialties,” said Herman A. Berliner, an economist and the dean of the Frank G. Zarb School of Business at Hofstra University. “When I was growing up, it was only a doctor. It’s far more efficient now.”
Both nurse practitioners and physician assistants can prescribe medicine in New York State. To become a nurse practitioner, an individual must obtain a master’s degree, after first getting a bachelor’s degree in nursing and being licensed as a registered nurse. In most cases, physician assistants also have a master’s degree.
Nurse practitioners are certified in a specialty, such as adult acute care, pediatrics or mental health, while a physician assistant’s certification is general.
The state Labor Department predicts a 28.4 percent jump in nurse practitioners on Long Island, and a 33.6 percent increase in physician assistants from 2012 to 2022. There were 1,780 nurse practitioners and 2,370 physician assistants on Long Island in the first quarter of 2016, according to state Labor Department data.
Entry-level nurse practitioners on Long Island make $97,920 on average, and starting physician assistants here make $74,130, according to Labor Department data from the first quarter of 2016. The median salary for nurse practitioners on Long Island is $115,870, and for physician assistants it is $107,930.
Local universities and colleges said interest in their programs has jumped in recent years.
The 250 nurse practitioner students expected to graduate at Stony Brook University this May are entering a strong job market, said Lori Escallier, an associate dean at Stony Brook University School of Nursing.
“We have increased our enrollment to the maximum, and there is great interest because it’s a golden egg, employment is very good and the work is so rewarding,” Escallier said.
Even though interest in the jobs has grown, health care executives are concerned that there may not be enough new workers to fill the demand.
Many nurse practitioners and registered nurses who deferred retirement during the financial crisis now plan to retire, health care experts said.
“We knew the time would come when nurses would want to retire,” said Kevin Dahill, chief executive of the Nassau-Suffolk Hospital Council, which lobbies on behalf of 23 member hospitals. “So, yes, I’m worried. The nursing schools are at full tilt, but there is a lot of competition for the talent. We knew this was going to come home to roost, and here we are.”
Physician assistants are less likely to be near retirement age because the profession gained popularity more recently, Hofstra’s Berliner said.
Graying of LI fuels growth
The rising demand for nurse practitioners and physician assistants reflects the growing health care industry on Long Island. The state labor department predicts the Island will add 47,080 health care jobs from 2012 to 2022, a 23 percent increase. That’s about twice the overall employment growth rate, projected to be 11 percent.
The state also forecasts a 15 percent increase in registered nurses, a 14 percent increase in dentists, and an 18 percent climb in surgeons on Long Island.
“When you look at the graying of America, that includes those of us in health care,” said Kathleen Gallo, senior vice president and chief learning officer at Northwell Health, the New Hyde Park-based health system. “The people retiring become patients on the other end, so there is a need for succession planning at all levels of health care.”
Long Island is grayer than the nation. Census data show that 15.4 percent of Islanders were older than 65 in 2015, compared with 14.1 percent nationally. The national number is expected to exceed 20 percent by 2030.
“There is a dramatic increase in older individuals,” Berliner said. “They say 70 is the new 50. That’s only with the right care and support.”
More people are accessing health care as well. On Long Island, 334,343 people have gained health care coverage since the 2010 passage of the Affordable Care Act, also known as Obamacare, according to the Nassau-Suffolk Hospital Council.
About 20 million people nationwide obtained coverage because of the ACA, according to the U.S. Department of Health & Human Services.
The Trump administration and Republicans in Congress have said they will repeal and replace the act, but no specific plan or timetable has emerged.
A repeal with no replacement program could hurt the health care job market, but Berliner said it was “premature to worry.” Taking health care away from the newly insured could create political backlash, he said.
Jobs set before graduation
Nurse practitioner and physician assistant graduates are readily finding jobs. They report getting emails from nearly every health system months ahead of graduation. Some landed jobs nearly two months before earning their degrees.
Brendan Walter, 24, of West Islip, who graduated from Hofstra’s School of Graduate Nursing Physician Assistant Studies program in December, agreed to join Northwell’s North Shore University Hospital in November. He will work in cardiothoracic surgery.
Jhad Mozeb, 24, of Uniondale graduated alongside Walter and wanted to work in internal medicine. A month before graduation he also agreed to join North Shore University Hospital in his desired field.
Meanwhile, Courtney Pilnick, 23, of Bellmore, another December Hofstra graduate, expects to get a physician assistant job in her desired field of pediatrics at the Children’s Hospital at Montefiore in the Bronx.
“I worked at a day care and as a camp counselor, and I’ve always enjoyed working with kids,” Pilnick said. “When they need medical attention some people think they’re little adults. They’re not. They are a unique population in medicine.”
She also accepted a part-time position at Bellmore-Merrick Pediatrics & Adolescent Medicine in Bellmore.
“Now I’ll be able to get hospital and office experience,” Pilnick said.
Today’s graduates are fortunate, said Carina Loscalzo, the chair and program director of the Department of Physician Assistant Studies program at Hofstra.
“The students are definitely getting jobs easier now.” she said. “The market has been great for quite some time, but [in the past] only a handful of them had jobs before graduation. Now more than half of them had jobs before graduation.”
Molloy College graduates about 125 nurse practitioners each year, and its graduates are “always in great demand, and that is particularly true the last few years,” said Jeannine Muldoon, dean of Molloy’s Barbara H. Hagan School of Nursing.
Adelphi University plans to graduate 40 nurse practitioners in May, and they will be entering a market “with a large demand,” said Elaine Smith, acting dean of the Adelphi University College of Nursing and Public Health.
Northwell, which employs about 1,400 nurse practitioners and physician assistants, has added nearly 200 to its staff in the last year. Some filled vacated jobs, but most were new positions, said Northwell chief people officer Joseph Moscola.
Catholic Health Services employs a total of 200 to 300 nurse practitioners and physician assistants, said Tony Pellicano, chief human resources officer at Catholic Health Services.
“We see that number going up quite a bit,” Pellicano said.
One reason nurse practitioners and physician assistants are in demand is that they take some of the workload off doctors, who are also in short supply.
“A highly paid MD doesn’t need to handle routine ear infections,” Berliner said. “Since there is a strong demand, there will be a bump up on how much nurse practitioners are paid. I would make the same statement about physician assistants. Robust demand and measured increases in supply will lead to salary increases.”
Michele Salvadori, 52, of Massapequa Park, has been a nurse practitioner at Northwell Health Physician Partners’ Massapequa Heart Associates in Seaford since she graduated with a master’s degree from Adelphi in 1998. She said she earns more than $115,000 and routinely handles long-term patients.
“Nurse practitioners are great at handling chronic conditions,” she said. “I can spend 30 minutes with a patient and educate them, because with educated patients, outcomes are better.”
Salvadori said the doctors at the practice refer patients to her who are either at risk or struggling with heart health issues.
Saving on cost of care
It saves money when nurse practitioners or physician assistants handle chronic patients, said Veronica Lopez, director of talent acquisition at Winthrop-University Hospital in Mineola.
“It’s about preventive care,” Lopez said. “If we manage their care, the patient won’t always be back in the hospital. The hospital visits are expensive.”
Some health systems are looking inward to find talent. Catholic Health Services is offering tuition reimbursement if any of its more than 3,000 registered nurses want to go back for a master’s, Pellicano said.
“It’s so competitive, so we have to hold on to the ones we have, develop a pool of new candidates and tap into our current staff to get them the training, and get them the right credentials,” Pellicano said.
Other hospitals, including Northwell’s, South Nassau Communities Hospital in Oceanside, Southampton Hospital, John T. Mather Memorial Hospital in Port Jefferson and Winthrop offer similar benefits.
Professionals also get unsolicited interest from competing institutions trying to build their staffs.
“I get job offers daily,” said Joan Ginty, a nurse practitioner for 28 years and the associate dean of the doctor of nursing practice program at Molloy College. “But I like my job at Molloy.”